- Centene Corporation (Jefferson City, MO)
- …on workplace flexibility. BCBA Preferred ABA Team **Position Purpose:** Manages the behavioral health (BH) utilization review clinicians to ensure ... to member care, provider interactions, and facilitates operations within utilization management. + Manages behavioral health...and Family Therapist (LMFT) required or + Licensed Mental Health Professional (LMHP) required or + RN… more
- Blue Cross and Blue Shield of Louisiana (Baton Rouge, LA)
- …or relocation to Louisiana is preferred for all positions. **POSITION PURPOSE** The Behavioral Health Utilization Reviewer is responsible for conducting ... clinical reviews of behavioral health service requests, claims, and appeals...to providers and members in a clear, timely, and professional manner. **How You Contribute to the Company's Mission… more
- Centene Corporation (Springfield, IL)
- …in accordance with regulatory guidelines and criteria + Performs concurrent review of behavioral health (BH) inpatient to determine overall health of ... outlined by the applicable state required. Master's degree for behavioral health clinicians required. Clinical knowledge and...and Family Therapist (LMFT) required or + Licensed Mental Health Professional (LMHP) required or + RN… more
- AmeriHealth Caritas (Lafayette, LA)
- **Role Overview:** Under the direction of the Supervisor, the Behavioral Health Utilization Management (BHUM) Reviewer is responsible for completing medical ... request clarification. The BH UM Reviewer will use his/her professional judgment to evaluate the request to ensure that...in Social Work. + Minimum of 2 years of behavioral health experience and substance use disorder… more
- Blue Cross and Blue Shield of Louisiana (Baton Rouge, LA)
- …insurance ABA coverage policies. + Experience with interprofessional collaboration in behavioral health settings. _The Physical Demands described here are ... all positions. **POSITION PURPOSE** . The Board Certified Behavior Analyst (BCBA), Utilization Reviewer role is responsible for evaluating the medical necessity and… more
- Centene Corporation (Madison, WI)
- …the one who changes everything for our 28 million members as a clinical professional on our Medical Management/ Health Services team. Centene is a diversified, ... hour Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time… more
- UnityPoint Health (Cedar Rapids, IA)
- …+ Job ID: 168048 Overview The Utilization Management Specialist in the Behavioral Health Hospital Outpatient Departments serves a key role in coordinating ... the department's interdisciplinary effort to assess and promote appropriate utilization of health care resources, provision of...related field or an RN + Two years of behavioral health work experience. + Professional… more
- Molina Healthcare (NM)
- …Association** Active, unrestricted Utilization Management Certification (CPHM), Certified Professional in Health Care Quality (CPHQ), or other healthcare ... plan and coordinate an integrated delivery of care across the continuum, including behavioral health and long-term care, for members with high need potential.… more
- Centene Corporation (Tallahassee, FL)
- …experience in applied behavioral analytics (ABA). Additional Details: * Department: Behavioral Health Utilization Management * Business Unit: Corporate / ... of care and services are medically appropriate related to behavioral health (BH) and/or autism spectrum disorder...and Family Therapist (LMFT) required or + Licensed Mental Health Professional (LMHP) required or + RN… more
- Banner Health (Glendale, AZ)
- …want to be part of, we want to hear from you. Bring your passion for Behavioral Health to **Banner Thunderbird Medical Center!** Our Behavioral Health ... mental health diagnoses as well as those behavioral health patients whom have co-morbidities that...of care and develops, implements, monitors and documents the utilization of resources and progress of the patient through… more